Two Toxicologists on Saraqib Symptoms

April 24, 2021

I already had this incident of February 4, 2018 covered fairly well in the post The Nonsense Gassing of Militants in Saraqeb - a part of my project Re-Considering the IIT's Nine Unsolved CW Cases. The news is that the findings are in: the OPCW's Investigation and Identification Team found all contrary claim to be nonsense, and that it's "reasonable" to believe that Syria's military did that, and now we're all supposed to believe it. The IIT releases its second report (press release - PDF direct link) just in time for the Conference of State's Parties where Syria was stripped of its rights (Syriana Analysis or Saudi-owned Al-Araby). 

I've been a bit slo to write about this, and now I'm just looking at a couple of aspects. But first a quick review of the chlorine cylinder "impacts." That's an issue I'll have to consider in another post, but I suspect they fell right here from above, and maybe at a very slight angle ... probably after reaching an arc following a steep-angle launch from the surface nearby. The how is unknown but possible, as far as I know, and tricky enough that I have to leave other fakery (hydraulic press, etc. - on-site or off - grass bleaching faked or coincidental, craters made with something else to be explained) or helicopter drop as PHYSICAL possibilities.

Explaining Away the Sarin

Otherwise, there's a lot of strangeness to consider here, like their answer to the illogical sarin-chlorine allegations that were backed up by actual sarin returns. The same would be claimed in Douma in April; sarin and chlorine barrel bombs killed over 180 at activist last count before they reverted to 42, and then just chlorine was found. It seems to me that story was supposed to go somewhere, but it got messed up, presumably in the chaos of total defeat for Islamist forces. And it seems to me Saraqib was supposed to be the illustrative prelude, hence a devious (and essentially impossible) "Assad chemical trick" - sneaking sarin back in under cover of the more boring chlorine. 

IIT report 2 decides: To attack with both sarin and chlorine at once was illogical and improbable, besides poorly-illustrated, as their experts had to admit. So the Identifiers set to correcting the record with no foul called. The sarin was just there in the dirt already. Who knows why. 

There was a separate question of whether normal sarin breakdown products should be found or chlorinated ones. I didn't see that answered here. If they should be chlorinated by the chlorine and aren't, that means they weren't in the attack OR in the soil already, but added later. That would be leading sample contamination - the kind of thing the OPCW thinks it can avoid having rebels videotape their scooping and sealing of samples, while having no clue if anyone had already messed with the site (or seeing clues they decided to ignore?).

The sarin-like symptoms reported would need explained away. Sure, the miosis was never real, at least not for all 11 patients as reported. ("pinpoint or constricted pupils, firmly established by the IIT in two individuals only"). And no foul called for leadingly exaggerating a mismatching symptom. But there were others that seemed odd, and now must be caused by just chlorine. As it happens, the experts agreed - both of them - that it all lined up just fine. 

6.44 Two experts (toxicologists) assessed the FFM Report on Saraqib, photographs, and information provided by witnesses – including medical personnel – on symptoms and treatment of victims involved in the incident of 4 February 2018. The toxicologists, after reviewing relevant medical literature, independently checked each account from witnesses (victims or other eyewitnesses to the symptoms) against the symptoms that could be expected from chlorine exposure. They also considered imagery related to the treatment received by the victims. 

6.45 On the basis of the material provided to them, the two toxicologists reached a shared conclusion, i.e., that the accounts of victims (three of whom were among the first responders) and medical personnel – despite some marginal discrepancies – are consistent with exposure to a toxic gas like chlorine, which is poisonous and classified as a pulmonary irritant. The two toxicologists did not express doubts as to the overall veracity of the accounts. ...

We'll have a look at that, but first at a way these experts were more passively used by the IIT to make a pointless point that misses a much bigger point.

Review: Gas Spread

Next: the toxicologists correctly deduced who should and shouldn't be seriously exposed, without being led there by anyone being identified. Just from the symptoms described by anonymous person X Y or Z, basically, they agreed the ones with the worst reported effects wind up being the same ones who reported being closer to the gas: the event made basic sense, or at least the story was gotten straight. 

"...the victims considered by the expert toxicologists to have symptoms consistent with exposure to irritating gas are those from the shelter, as well as the two first responders. The witnesses deemed to be “unlikely exposed” by the expert toxicologists were either those responders that only assisted in the later transfer of the victims to the Sarmin field hospital or were part of the medical staff (who would have all had much later exposure and were better equipped with protective equipment)."

(otherwise it's three affected "SCD" White Helmets responders). It was initially 6, 8, or 9 men in a shelter, depending on reports, several in camouflage pants, app. all militants claiming to all be civilians. In IIT report 2, it was 7 "individuals" in the shelter effected, plus 3 rescuers, implicitly 2 others from the whole town, one treated at the clinic and one not, out of 12 named individuals who reported experiencing any symptoms. One of them should be this guy:

Manhal Haj Hussein “At about 9 pm, while I was sitting and my family at home, we heard a helicopter approaching the place, and only a few minutes until we started smelling a strange smell inside the house. Then, I fainted, and then the civil defense teams arrived and took me to the hospital...” 

His apparent son, by name - Hasan Manhal Haj Hussein, age 22 - happened to be one of those affected in the fateful shelter, along with an apparent cousin, Dammar Hasan Haj Hussein, 36. The other non-shelter witness at the time was another relative: Ali Hajj Hussein: at "home with his pregnant wife and two children" - heard helicopters, something falling, then screams in the neighborhood. Luckily none of those screaming people needed any medical help, because reportedly just 1 non-shelter person in the town got treatment at what seems to be the only functioning clinic around. 

The other witness I've heard from, speaking later, has a different name, and says his father was one of those in the shelter (apparently being Haithan Amad Kafrtouni, age 53), and was since killed in an airstrike while helping people (not in the course of being an antigovernment militant). There are probably other witnesses out there, but when I was following close, it was 3/3 apparent - and mostly close - relatives with the shelter victims. It seemed a bit like the whole story was some project of a couple local families of some militants nobody else was in on, except a few unrelated militants and the White Helmets always around to help militants. 

The total exclusion of everyone else in this part of town from the story ... not an issue the IIT dwells on, if they even noticed it.

Bleach spots: seem to flow what's downhill there, then gets less discernable, maybe all-over, at the flatter ground. Suggested to me is little wind, leaving topography a serious issue. Mainly there seems to be little of that as well, so it would spread pretty widely, with a general trend wherever the breeze was headed. That may be north - that first flow probably isn't ALL downhill. 

"Crater 3" (top middle, black) may be a new crater, or an old one used as a burn pit more recently? Under the same breeze? Burning anything related to the chlorine cylinder 1 mysteriously found next to it? If so, wind that way, NNW, stronger than it seemed, and similar to the seen flow (so topography mattered less, it pooled up less, less likely to meander so far east as to flood that shelter (blue w/star).

As for wind, IIT hears from more credible sources than the OPCW has usually employed (mainly predictive model websites), or at least it sounds better: "The IIT established the meteorological situation in the area in the evening of 4 February 2018 through  concurring witness statements and other sources of information, including official reports received from the World Meteorological Organization (WMO) and its specialised meteorological centres" - in whatever mix. They got wind: "light, towards a northerly direction." - sounding rounded-off but likely about right. 

That makes the shelter seem like a reasonable place the gas would drift to - among quite a few other places. As they map likely areas of varying concentration, with estimated likelihood of severe symptoms, the shelter is a 40-50% likelihood by this. But it sounds like everyone there got really sick. (also note how red 50% zone's NE corner cuts off to avoid some likely inhabited buildings)

Annotated by me: excluded areas, at least judging by reports. They are mostly in the outer zone,  only 10% likely. But there are quite a few places where it's estimated 40% of the decent number living there should experience severe symptoms. A few less places than should be are in the red zone of 50%. Between them, IIT hears of two people with symptoms in all of that exempted space.

For the claims and the IIT's conclusions to reflect truth on this point almost requires the following: 

- a family shelter by 2 other home of the same family (which is possible enough - they'd probably be in the two houses immediately west and the upstairs part of the one with shelter: 3 buildings) ...

- ... with some mostly younger men in camo pants and non-relatives together in the shelter, everyone with children and pregnant women sitting upstairs in regular homes. 

- with almost no breeze, and a perfect topographical trough running not-so-straight to that block of 3 buildings and nowhere else (and that doesn't seems so absurd either, in itself, though images suggest that last part may be a bit uphill. To be decided, perhaps.)

- otherwise some other fluke had it all shift east at the road and then fuzz out to effect no one beyond that, or 

- a lot of other people were effected but never treated, never heard from or reported.

But the IIT were left at mild north wind and no special sub-trends, so a spread all over was likely. That's after they consulted experts on topography - not to find that magical trough, as they say, but to see if the terrain might explain the unusual symptoms reported. 

6.47 Although overall the symptoms of the victims are consistent with chlorine exposure, the IIT nonetheless proceeded to request from specialists the topographic analysis of the area, so that geographical and artificial features could be considered when assessing the accounts of witnesses and the likelihood of a chemical attack in an area with those characteristics. 

No, the topography doesn't change the symptoms of chlorine exposure, whether it make you black out or act goofy. Actual gas volume, release rate, wind, topography, all of that just affects concentrations of a gas that does nothing but burn. It is NOT and never was and never will be a nerve agent or anything like that. It doesn't mutate and do new things. It doesn't behave differently in one country vs. another or because the ground is so perfectly flat.

Symptoms Review

So ... the consulted experts found the symptoms to be "consistent with exposure to ... a pulmonary irritant" like chlorine. But worthy of note:

6.46 The toxicologists added that symptoms described in three out of 11 victims could also be consistent with exposure to a substance other than chlorine, such as organophosphates. 

(emphasis in original) But those 3 could just as likely be was from chlorine alone. And that's what it wound up being, since the sarin at the site was ... just already there, not freshly deployed.   

The toxicologists are right that chlorine is a pulmonary irritant, and that it's not anything else. From my readings into the subject, it turns to acid (hydrochloric and hypochlorous) on contact with water, and thus damages tissue (low-grade: "irritation"). This becomes especially problematic in the eyes and airways. It may separately limit oxygen absorption into the blood, but otherwise, it has no significant additional effects, neurological or otherwise. 

And yet the experts declare that the following symptoms all fits that bill, which I challenge with some notes.

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symptom reported        -        chlorine sign?         -        (notes, sarin compatibility)

Shortness of breath, coughing, wheezing - YES    -    (when breathing burns, the body auto-limits it (? I just reasoned that out) - chlorine may also block absorption of O2, and causes some actual damage to lung tissue, limiting function - protective mucous is produced, needs coughed out, later on can lead to suffocation. - With sarin, impurities may have a similar caustic effect, but breathing is more paralyzed than painful, more varied fluids are produced needing coughed out, yet coughing is less likely (same reason - breathing and coughing take muscle coordination, which tends to fail under bad sarin intoxication) 

Eye irritation    -    YES  -  (direct effect, corrosive tissue damage - but the impure sarin used in Syria also burns the eyes, FWIW) 

Nausea         - NO - (vomiting is often listed as a chlorine sign, but it's secondary - look it up - severe coughing can cause retching, thence vomiting, but not usually a feeling of nausea, and especially not a sudden one - sarin does that. The G and E is SLUDGE: gastrointestinal distress, emesis (vomiting, maybe a paralyzed, infantile form of it). And it comes on instantly. Several say as they approached the bomb craters, they felt "sick" swiftly enough to note it worsening with each step. Chlorine would best be described as burning worse with each step closer, and further out too, so they probably wouldn't BE walking closer, but rather away)

Excessive secretions - NO - (eyes will water to rinse out the acid, but no one calls that excessive, and usually would say "tears," not "secretions." - Sarin can or will make secretions pour out every pore, gland, and orifice. SLUDGE syndrome.)

loss of consciousness (LoC) (sudden) - NO (contrary to popular belief, chlorine has no relation to chloroform and what that does. * This JUST BURNS. That complicates breathing, as noted. The lower O2 levels usually take time to develop, but then will cause headache, fatigue, perhaps blackout, and death. It won't be remotely instant like people describe)

* they have same "chlor" surname, but that's not how name changes work in chemical marriages. Just kidding. 

Headache (if sudden) - NO - (chlorine: secondary to hypoxia, which takes a while to develop, usually - sarin: like most signs, headache comes on suddenly)

Dizziness     - NO - (AFAIK this should be like headache, fatigue, LoC - secondary and later on, in a severe case)

Miosis         - NO - (claimed for all 11 patients, IIT decides two have it, although chlorine doesn't cause it - it's the classic outward sign of sarin exposure everyone knows to look for)

"Leg weakness" (if sudden) - NO  - (chlorine: well into a severe cases with lowering oxygen levels, fatigue appears, often noted specifically in the legs (which they're using, to escape, because they did NOT just black out) - sarin: not a specific sign I know of, but could go with general paralysis, mild form, similar fatigue issues that appear much quicker) 

"Relaxed legs" - NO - (body parts not working right is not a chlorine thing - for sarin it is, but the paralysis tends to be rigid and trembling, not "relaxed.")

Altered mental state - NO - (if anything people sharpen up with the crisis of chlorine and do logical things like seek fresh air. - "two other patients presented with moderate signs and symptoms, displaying an altered mental state that required them to be assisted." One is seen on video laying down waving his hand in the air like he's conducting a symphony. - sarin paralyzes - complex movements like that become difficult, not optional and not involuntary.)

other:

"5.22 ... No secondary exposure was reported." - YES - (no secondary exposure with chlorine past a minor itch, perhaps - whereas it would be likely with sarin)

"5.36 No biomedical samples were taken." - ?? - (no point with chlorine, but with sarin, you'll want that proof. It was claimed, but maybe not "with a high degree of confidence." They didn't collect any samples to test their claims.)

"strange odor" - NO - (chlorine smells like bleach or other cleaning products, which isn't odd or strange to most people. Someone might say that anyway, but here 2+ describe it that way, and also say they passed out right away. Impure sarin: "foul" and "strange" are the most common words used for the smell. But quite a few chemicals out there will have similar smells from similar impurities)

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The IIT seems to be hitting rock bottom for experts here. Lucky for them, they weren't named, and their reputations won't be harmed. Unlucky for the people of Syria: they'll be trusted by many because the OPCW's IIT trusted them. Their shoddy work is already helping prolong the punishment of Syrians, apparently just for having a government our leaders don't like.

My Amateur View

There was probably no sarin exposure; despite some consistent signs, others conflict. The bleached grass and cylinders still suggest to me chlorine was released. Chlorine exposure with these militants seems pretty possible, despite the lack of visible red eyes (I haven't seen any that I recall, but I missed some evidence and got rusty). But if so, it clearly is not the whole story. 

It definitely doesn't sound like BZ/Agent 15 either (altered mental state, relaxed legs sounds good, secretions definitely not a fit, and we'd see dilated pupils, neither reported nor seen (that I've seen). That's almost my whole list of things I could say. I don't have any guess as to the relevant agent(s) except for: chosen, as part of this public deception.

Which isn't to say sarin wasn't used; it supposedly turned up in tests and now has to be awkwardly explained away. I'd say it was just used more like a movie prop - sprinkled or sprayed at the site of the chlorine cylinder "impacts." 

Basic gist of the conspiracy I theorize, starting from impact: they claim sarin-chlorine bomb attack, get some local militants poisoned with probably something else, unknown, have the medics fill in the key sarin details like miosis - get their few trusted witnesses on record, plant the sarin at the scene, carefully sample from the scene and document that to prove no tampering, get the sarin confirmed - then let someone else try to make sense of that mess later on.